What Pregnant Women Really Need When It Comes to Alcohol

A pregnant woman holding a glass of red wine
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If there's one thing society loves judging pregnant women about, it's their drinking habits. Have a glass of wine at the office Christmas party? Bad mom! Drink half of a sangria on your birthday? How selfish to put your own wants before your baby! Women are more than capable of sorting through the information and deciding whether or not we want to drink, but we're rarely trusted to do it. That's why I'm fist-pumping today over a new study about pregnancy and alcohol that shows not how women "should" choose to behave, but how we're more than capable of making our own damn decisions, thank you very much.

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You might remember last year when the Centers for Disease Control (CDC) came out with a bonkers statement encouraging basically every single woman of childbearing age (who isn't on birth control) to stop drinking. They reasoned that about half of all pregnancies are unplanned and their stance is that there is no safe time to drink during pregnancy, so women should stop drinking immediately, just in case. After all, women are just incubators who should always function according to the needs of hypothetical fetuses, right?

Wrong.

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After that disaster of a public health strategy came out, Katherine Hartmann, deputy director of the Institute for Medicine and Public Health at Vanderbilt University, decided to look back at some research she'd done on alcohol consumption and early pregnancy. Her findings were published this week in the journal Obstetrics and Gynecology, and they paint a much clearer picture of how pregnant women in the real world actually behave.

For her research, Hartmann looked at data about alcohol consumption for 5,036 pregnant women. Of those women, about half admitted they'd consumed alcohol during their first trimester, but the majority of them -- a whopping 90 percent, in fact -- also said they voluntarily stopped drinking as soon as they found out they were pregnant. Only about 6 percent of women chose to continue drinking while pregnant, and most of them reported having less than one drink per week.

"We thought that we would see this [pattern of abstaining from alcohol] among women who intended to be pregnant," Hartmann revealed in a press release regarding her research. "But we also saw it among almost 1,500 women who did not plan to be pregnant ... the date when they had a positive pregnancy test was almost identical to the date when they changed their alcohol use pattern, mostly stopping."

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Interestingly, Hartmann found it's educated, middle-class women who are most likely to continue drinking while pregnant. These women presumably know the risks and have access to a wealth of reliable prenatal advice, which flies in the face of assumptions by the CDC (or even just assumptions by judgy individuals) that pregnant women don't understand the potential consequences of that glass of chardonnay.

Obviously, no one wants to encourage drinking during pregnancy. Fetal alcohol spectrum disorder (FASD) is linked to low birth weights, vision and hearing problems, poor coordination, intellectual delays, and a host of other serious issues. In some areas, the CDC estimates FASD is present in .2 to 1.5 out of every 1,000 live births.

We can't discount the severity of FASD, but the way to prevent it is not to shame women, treat us like a bunch of know-nothings, or act like we're selfish idiots who simply don't care enough to change our habits. If we want to protect babies from FASD, Hartmann says we should start by reducing the number of unplanned pregnancies. That means making sure birth control is easily accessible, educating young people, and emphasizing the importance of taking a pregnancy test as soon as possible following a missed period.

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"At the time of a missed menstrual period, we say that someone is four weeks pregnant, but actually, the embryo is only two weeks old with only a limited time in the uterus with exposure to maternal tissue," Hartmann explained.

That means it's very unlikely that a fetus has been exposed to damaging amounts of alcohol very early in pregnancy. The sooner women know they're pregnant, the sooner they can stop or dramatically reduce their alcohol consumption. And, as this study shows, most women have no problem doing that, as long as they're empowered with the tools and information they need to make their own choices.

The bottom line? Trust women. We know our bodies, and we're more than capable of making smart decisions about our health.

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